Mark T. Wagner, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34.003690 Issued in OH

Practice address

1248 Kinneys LN
Portsmouth, OH 45662-2994

Phone

(740) 356-7290

Fax

(740) 356-7938

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

82.59 of 100Reported as group

Quality

59.57

Promoting interoperability

100

Improvement activities

40

Cost

71.16

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emergency Professional Services, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment NPD
• Emh Professional Services Inc.

  • Obstetrics & Gynecology Physician
  • Elyria, OH
  • NPI 1508951070

  Family Medicine

  NPD (past)
• ER-Doc Inc

  • Emergency Medicine Physician
  • Sandusky, OH
  • NPI 1922092014
  NPD (past)
• Midwest Emergency Management Ohio, Inc

  • Emergency Medicine Physician
  • Tiffin, OH
  • NPI 1154655850
  NPD (past)
• Midwest Emergency Services Ohio, Inc

  • Emergency Medicine Physician
  • Willard, OH
  • NPI 1326372038
  NPD (past)
• Ohio Em-I Medical Services Professional Association

  • Emergency Medicine Physician
  • Tiffin, OH
  • NPI 1255696480
  NPD (past)
• Physicians Link Center LLC

  • Emergency Medicine Physician
  • Elyria, OH
  • NPI 1235172925
  NPD (past)
• Tiffin Emergency Services, LLC

  • Emergency Medicine Physician
  • Tiffin, OH
  • NPI 1003874298
  NPD (past)
• Wood County Emergency Physicians Inc

  • Emergency Medicine Physician
  • Bowling Green, OH
  • NPI 1073863130
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1346373446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-8681",
            "fax_number": "740-353-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 KINNEYS LN",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622994",
            "telephone_number": "740-356-7290",
            "fax_number": "740-356-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MARK",
        "middle_name": "T.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34003690W",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.003690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0557642",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.wagner@somc.medicity.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1248 Kinneys Ln",
            "city": "Portsmouth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456622994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Voiers
• Gwendolyn Voreh-Sexton
• Horia Vulpe, MD, CM
• Amber Waddell
• Chase Wagner, LPC
• Judith F Waldron, LCDCIII, CDCA
• David S Walker, M.D.
• Heather Lynn Walker, RN
• Richard Wallace
• Sarah Wallace, LPN

• Family Medicine Physician in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.